if you want to maximise health attend to the population an awful lot of what
you're going to touch is non-medical making sure that people can find and keep good
work making sure that children start school ready to learn and ready to
thrive a shift from a reactive crisis driven health system to something that's
defined by its ability to kind of provide and coordinate reliable early
help it will be lovely just to drive transformation but the bottom line is
that I'm afraid we're doing this in an incredible headwind both in terms of
finance in terms of you know the performance of the system in Greater
Manchester we're doing it across you know ten localities serving nearly three
million people 33 health and care organisations playing a part in this we
realised that actually the start line for transformation for some
organisations some localities some individual service areas actually is a
distance away there will be events as well the morning of the 23rd of May last
year and I was given the task of saying of coordinating a mental health response
and for the victims of the attack at Manchester Arena and actually within
about eight hours I had practitioners from every Mental Health Trust in
Greater Manchester I had representatives from every
Children's Service Department in every Council and we set up the organisation
broad Manchester resilience up within six weeks of the attack and we're doing
proactive screening and proactive support to all of the victims
regardless of where they lived I'm not sure we would have reacted that quickly
with that much clarity if we hadn't been on this and journey together around
integration I would see part of Greater Manchester's kind of stratigraphy as an
impulse to collaborate one of the things that we'd we'd confronted over the over
the last year 18 months from the election of the mayor in particular was
a specific focus on a Greater Manchester's rough sleeping and
homelessness problem and one of the things that we were able to do quite
quickly was kind of convene a conversation so we find out from
representatives and providers what they're going to bring to the table what
can they offer and we find out from even that Fire and Rescue Service and
they can make use of some of their capacity assets and resources and from
our part we were looking to to connect our discharge protocols from every every
hospital and something that didn't discharge people onto the street looking
to make sure that homeless people could register with GPS looking to coordinate
our work around around every support for mental health and substance use and
misuse services so that default and collaboration is something you can move
quite quickly once it becomes practiced you can't integrate
health and social care from Greater Manchester this has got to be this has
got to be kind of boots on the ground activity and the task as much as
anything is to ignite the participation of every part every part on every
practitioner and every resident in Greater Manchester we can also
collaborate and drive out some of the variation if we if we take a step in
terms of commissioning according to the same set of standards so we did this
last year on the ADHD services so recognising where actually the points of
connection ought to be made certain institutions generate their own their
own rules their own norms and if we don't recognise this collaboration is
going to be really really hard there is an opportunity like an airport to almost
operate ourselves as if we were a single entity if you think about the ownership
of airports that's got that bizarre mix of you know public-private government
but actually the experience of was passing through and having an experience
which is partly that other travel and partly that of a shopper and gives us a
bit of a lesson about the extent to which you can you can generate something
that feels coherent and whole without necessarily having to grab the ownership
at any one level it's definitely essential for us to integrate health and
social care but it won't answer the big question of how we maximise the health
of a defined population and if we get people more comfortable by saying
actually you can join this just plug yourselves in come on the
journey with us you've got a contribution to make and you've got some
benefits to take back we can truly kind of extend where we where we start to
make a difference so we started a conversation a couple years ago with the
schools across Greater Manchester booked a big room said you want to come in and
see how we can connect in terms of improving the health and emotional
well-being of schoolchildren in Greater Manchester
250 soup 250 representatives to 250 schools came on at a moment's
notice and we started then to think about what can we do in terms of
mentioned mental health emotional support provision in schools and we've
got 31 schools signed up within a fortnight so suddenly you find that
you're not wrestling just with the financial difficulties in health and
care system because there are new assets and resources to be able to plug in I
love the idea of the disruption of saying we all work for the population in
the place leave your baggage at the door and I've realised over the last couple
years it's not possible you can't disconnect people from the baggage and
there's a there's a real risk that it mobilises resistance if people think
that you are doing it so there is still a real feeling for the providers to me
it's providers and the CCGs to meet at CCGs and the council's to meet as
councils as groups and we let all of that happen because actually they like
getting stuff off their chests with each other and then we've got more of a
chance of saying so what is it that we can agree on there is something about
the the discipline that we need to bring to the program management and
coordination of 320 things across 33 organisations with hundreds and hundreds
of leaders playing across it but at the same time not losing that sense of of
where the creativity comes from and our biggest lesson I think over the course
of the last the last year if you think of the all that conversation about
integrated care organisations and the extent to which it was utterly flattened
by discussions about complex contracts and organisational form and packs and
MCP and all that kind of stuff I think where we've seen real action and we've
seen most of the the faster-moving benefits to services for residents is
wave said no the key bit here is that what however we integrate the most
meaningful level will be in those neighborhoods thirty to fifty thousand
neighbourhoods it feels a good point for primary care to connect it feels a good
point for wider public services to connect it feels like a good point to be
relevant and recognisable to to populations across Greater Manchester
and what we found is that those people that were struggling with we're not
really sure what organisational form we're going to go for and we just said
don't worry about that get the stuff happening in the
neighbourhoods as we've seen pure gold so I'm not worrying too much about
letting the the kind of creativity room slightly ahead of the organisational
form and contract form because I think that's that stuff catches
and I think I'm certain amount of time so hope that was helpful thank you very
much.